Considerations for an Individual Mandate for the District of Columbia Jason Levitis State Health and Value Strategies January 23, 2018 1
About Jason Levitis: Jason Levitis, Levitis Strategies LLC. Jason is a health policy expert focusing on the Affordable Care Act’s (ACA) tax measures and state innovation waivers. Until January 2017 he led ACA implementation at the U.S. Treasury Department. He currently provides technical assistance to states on behalf of State Health and Value Strategies. He is also a senior fellow at Yale Law School’s Solomon Center for Health Law and Policy, and a non-resident fellow at the Brookings Institution. He is a resident of the District of Columbia. About State Health and Value Strategies: State Health and Value Strategies (SHVS) assists states in their efforts to transform health and health care by providing targeted technical assistance to state officials and agencies. The program is a grantee of the Robert Wood Johnson Foundation, led by staff at Princeton University’s Woodrow Wilson School of Public and International Affairs. The program connects states with experts and peers to undertake health care transformation initiatives. By engaging state officials, the program provides lessons learned, highlights successful strategies, and brings together states with experts in the field. Learn more at www.statenetwork.org. 2
General Approach Implement through DC Income Tax • Single line on tax return Use Federal Law as Starting Point Maximizes continuity and eases compliance amid short implementation • timeline • Simplifies legislative drafting and incorporation of Federal guidance • Reduces re-litigation and “winners and losers” Adjust for State Context and Policy Preferences • Modify for State legal framework and terminology • Make specific policy changes as desired 3
Key Components I. Individual Mandate • Definition of qualifying coverage • Exemptions • Penalty calculation II. Reporting Requirement for Certain Coverage Providers Requires only nominal effort on top of Federal reporting • • Federal programs exempted III. Procedures for Granting Certain Exemptions DCHBX grants exemptions for hardship and religious conscience • IV. Notification of Uninsured about Coverage Options (optional) 4
Potential Changes to Federal Rules Addressing Substandard Plans • May require consumer protections (like Mass.) or simply exclude • May include/exclude AHPs, health sharing ministries, grandfathered plans, certain employer coverage Interaction with Federal Mandate Penalty • May allow credit for Federal penalty in the event it is reinstated to avert any possible double-payment (like Mass.) Change penalty amounts and exemption rules 5
Contact Information and Resources Contact information: Jason Levitis jason.levitis@gmail.com Model Legislation: http://www.statenetwork.org/resource/model-legislation-for-state-individual-mandate/ 6
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